TY - JOUR
T1 - General practitioners' clinical decision-making in patients that could have cancer
T2 - a vignette study comparing the Baltic states with four Nordic countries
AU - Rosendahl, Alexander
AU - Vanaveski, Anet
AU - Pilv-Toom, Liina
AU - Blumfelds, Jānis
AU - Siliņa, Vija
AU - Brekke, Mette
AU - Koskela, Tuomas
AU - Rapalavičius, Aurimas
AU - Thulesius, Hans
AU - Vedsted, Peter
AU - Harris, Michael
N1 - Publisher Copyright:
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2025/6
Y1 - 2025/6
N2 - OBJECTIVE: Relative one-year cancer survival rates in the Baltic states are lower than the European mean; in the Nordic countries they are higher than the mean. This study investigated the likelihood of General Practitioners (GPs) investigating or referring patients with a low but significant risk of cancer in these two regions, and how this was affected by GP demographics.DESIGN: A survey of GPs using clinical vignettes.SETTING: General Practice in Denmark, Estonia, Finland, Latvia, Lithuania, Norway, and Sweden.SUBJECTS: General Practitioners.OUTCOME MEASURES: A regional comparison of GPs' stated immediate diagnostic actions (whether or not they would perform a key diagnostic test and/or refer to a specialist) for patients with a low but significant risk of cancer (between 1.2 and 3.6%).RESULTS: Of the 427 GPs that completed the questionnaire, those in the Baltic states, and GPs that were more experienced, were more likely to arrange a key diagnostic test and/or refer their patient to a specialist than those in Nordic Countries or who were less experienced (
p < 0.001 for both measures). Neither GP sex nor practice location within a country showed a significant association with these measures.
CONCLUSION: While relative one-year cancer survival rates are lower in the Baltic states than in four Nordic countries, we found no evidence that this is due to their GPs' reluctance to take immediate diagnostic action, as GPs in the Baltic states were more likely to investigate and/or refer at the first consultation. Research on patient and secondary care factors is needed to explain the survival differences.
AB - OBJECTIVE: Relative one-year cancer survival rates in the Baltic states are lower than the European mean; in the Nordic countries they are higher than the mean. This study investigated the likelihood of General Practitioners (GPs) investigating or referring patients with a low but significant risk of cancer in these two regions, and how this was affected by GP demographics.DESIGN: A survey of GPs using clinical vignettes.SETTING: General Practice in Denmark, Estonia, Finland, Latvia, Lithuania, Norway, and Sweden.SUBJECTS: General Practitioners.OUTCOME MEASURES: A regional comparison of GPs' stated immediate diagnostic actions (whether or not they would perform a key diagnostic test and/or refer to a specialist) for patients with a low but significant risk of cancer (between 1.2 and 3.6%).RESULTS: Of the 427 GPs that completed the questionnaire, those in the Baltic states, and GPs that were more experienced, were more likely to arrange a key diagnostic test and/or refer their patient to a specialist than those in Nordic Countries or who were less experienced (
p < 0.001 for both measures). Neither GP sex nor practice location within a country showed a significant association with these measures.
CONCLUSION: While relative one-year cancer survival rates are lower in the Baltic states than in four Nordic countries, we found no evidence that this is due to their GPs' reluctance to take immediate diagnostic action, as GPs in the Baltic states were more likely to investigate and/or refer at the first consultation. Research on patient and secondary care factors is needed to explain the survival differences.
KW - Cancer
KW - early diagnosis
KW - general practice
KW - geography
KW - primary health care
UR - https://www-webofscience-com.db.rsu.lv/wos/alldb/full-record/MEDLINE:39838273
UR - https://pubmed.ncbi.nlm.nih.gov/39838273/
UR - http://www.scopus.com/inward/record.url?scp=85215765822&partnerID=8YFLogxK
U2 - 10.1080/02813432.2025.2451653
DO - 10.1080/02813432.2025.2451653
M3 - Article
C2 - 39838273
SN - 0281-3432
VL - 43
SP - 403
EP - 410
JO - Scandinavian Journal of Primary Health Care
JF - Scandinavian Journal of Primary Health Care
IS - 2
ER -
